ICD-10-PCS Billable Code

0LB43ZZ

Excision Upper Arm Tendon, Left to No Qualifier with No Device, Percutaneous Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemL Tendons
OperationB Excision
Body Part4 Upper Arm Tendon, Left
Approach3 Percutaneous
DeviceZ No Device
QualifierZ No Qualifier

Operation Definition

Cutting out or off, without replacement, a portion of a body part

Procedure Overview

Tendon excision procedures cut out and remove a portion of a tendon without replacing it, typically to address a tumor, a chronically degenerated segment, a painful nodule, or scar tissue that is limiting motion. A well-known example is excision of a trigger finger nodule or a portion of tendon affected by tenosynovitis that has not responded to more conservative treatment, as well as biopsy of a suspicious mass for diagnostic purposes.

Because only part of the tendon is taken and the remainder is left in place, the surgeon must weigh how much tissue can be safely removed without compromising the tendon's mechanical function. In many cases the excised tissue is sent to pathology, which both confirms the diagnosis and distinguishes this procedure from techniques that simply destroy tissue in place.

Anatomy & Axis Detail

Upper Arm Tendon, Left

The left upper arm's biceps and triceps tendons undergo excision under the same clinical circumstances as the right - chronic tendinosis, partial tears, or symptomatic scar tissue that limits elbow motion. Surgeons removing a portion of either tendon aim to eliminate the diseased segment while preserving enough length for the muscle-tendon unit to function, distinguishing this cleanly from procedures that reattach or replace tissue. Given handedness effects on tendon loading, left-sided pathology is common in left-hand-dominant patients performing repetitive lifting or throwing motions. Precise laterality and tendon identification in the documentation matter because upper arm tendon excisions can be mistaken for adjacent muscle or bursal procedures if the operative report is ambiguous.

Approach: Percutaneous

Percutaneous describes entry by needle or instrument puncture through the skin or mucous membrane to reach the site of the procedure, without cutting the tissue open or using a visualizing scope. It differs from Open in that the site itself is never exposed, and from Percutaneous Endoscopic in that no endoscope is used to see internal structures. Common examples include needle biopsies and injections.

Coding & Documentation

A code from this family is appropriate when the operative note documents cutting out and removing a defined portion of tendon tissue, with the remaining tendon left intact and nothing reconstructed at the same time. Look for language describing a specimen sent to pathology, the anatomic tendon and location, and confirmation that the entire tendon was not removed, which would instead point toward Resection.

A common mistake is coding Excision when the whole tendon was actually removed, since ICD-10-PCS distinguishes cutting out "all or a portion" only when characterizing the two operations differently, that is, Excision for a portion and Resection for all of a body part. Coders also sometimes overlook a concurrent repair, such as a tendon graft or suture closure performed after excision, which requires a separate code if it meaningfully restores structure beyond simple wound closure.

Commonly Confused With

ResectionResection is the closest neighbor and the distinction hinges entirely on whether the entire tendon was removed versus only a segment.
ExtirpationExtirpation can be confused with Excision when a mass being removed is actually loose or abnormal solid matter, like a foreign body or a discrete calcified nodule not integrated into the tendon structure, rather than a piece of the tendon itself.
DestructionDestruction differs because it eradicates tissue without physically removing it from the body, so no specimen exists for pathology, which is a helpful clue when the documentation is otherwise ambiguous.